Access to antivenoms in the developing world: A multidisciplinary analysis.

Area of Science:

• * Global Health
• * Pharmacovigilance
• * Tropical Medicine

Background:

• * Snakebite envenoming is a significant global health issue, disproportionately affecting tropical and subtropical regions.
• * Access to safe, effective, and quality-assured antivenom is critical for managing snakebite envenoming but faces numerous challenges.
• * Current efforts to reduce the burden of snakebite envenoming are hampered by multifaceted access barriers to antivenom products.

Purpose of the Study:

• * To review the antivenom ecosystem and identify barriers to antivenom access at global, national, and local levels.
• * To propose solutions for overcoming challenges in antivenom procurement, regulation, financing, and distribution.
• * To inform strategies for improving antivenom availability and accessibility in resource-limited settings.

Main Methods:

• * A comprehensive review of the antivenom supply chain and access landscape.
• * Analysis of barriers at global (manufacturing), national (regulation, funding), and local (supply, cost, misconceptions) levels.
• * Identification of actionable solutions aligned with the WHO Strategy for Prevention and Control of Snakebite Envenoming.

Main Results:

• * Global manufacturing output is insufficient to meet clinical needs, especially in regions with limited producers.
• * National-level issues include variable funding, inadequate regulation, and failure to register products locally.
• * Patient-borne costs, unreliable peripheral supply chains, and misconceptions about treatment further impede access and appropriate use.

Conclusions:

• * Multifaceted interventions are essential to improve antivenom access in resource-limited settings.
• * Strengthening manufacturing, regulation, financing, and supply chains is crucial.
• * Addressing patient-level barriers and misconceptions is vital to reduce the global burden of snakebite envenoming.